Analysis of High-risk Factors for Death in Infants with Severe Pneumonia_West China Medical Journal

Authors：

 LIMao-xia ^1,2 ,  WANChao-min ¹ , LEIMing-yu ²

1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Emergency, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan 610091, P. R. China;

Corresponding author：

WANChao-min, Email: wcm0220@sina.com

Keywords：

Severe pneumonia; Infants; Death; High-risk factors

DOI：

10.7507/1002-0179.20140516

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Objective To investigate the high-risk factors for death in infants with severe pneumonia. Methods We analyzed hospitalized infants and young children diagnosed with severe pneumonia from January 2011 to December 2013, and investigated the risk factors for death. Results A total of 1 411 infants with severe pneumonia were included in the analysis. The mortality rate was 3.12%. In single factor analysis, the following factors were significant:age, severe infection, artificial feeding, congenital heart diseases, bad habitation, repeated infection history, surgical history, multi-organ dysfunction, internal environment disorder, multiple drug-resistant strains infection. The results of Logistic multiple regression analysis showed that there were statistical significance in severe infection, repeated infection history, Multiple drug-resistant strains infection, multi-organ dysfunction, and internal environment disorder. Conclusion Infants with severe pneumonia should be intensively monitored and actively treated for reducing the mortality rate if they have one of the following high-risk factors:age, congenital heart diseases, repeated infection history, multiple drug-resistant strains infection, surgical history, multi-organ dysfunction, and internal environment disorder.

Citation： LIMao-xia, WANChao-min, LEIMing-yu. Analysis of High-risk Factors for Death in Infants with Severe Pneumonia. West China Medical Journal, 2014, 29(9): 1693-1696. doi: 10.7507/1002-0179.20140516 Copy

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1. 王卫平,毛萌,李廷玉,等.儿科学[M].8版.北京:人民卫生出版社,2013:277.
2. 中华医学会儿科学分会呼吸学组,中华儿科杂志编辑委员会.儿童社区获得性肺炎管理指南(试行)(上)[J].中华儿科杂志,2007,45(2):83-90.
3. British Thoracic Society of standards of care committee.BTS guidelines for the community acquired pneumonia in childhood[J].Thorax,2002,57(Suppl):S1-S24.
4. Rudan I,Boschi-Pinto C,Biloglav ZA,et al.Epidemiology and etiology of childhood pneumonia[J].Bull World Health Organ,2008,86(5):408-416.
5. Singh V,Aneja S.Pneumonia-management in the developing world[J].Paediatr Respir Rev,2011,12(1):52-59.
6. Scott JA,Brooks WA,Peiris JS,et al.Pneumonia research to reduce childhood mortality in the developing world[J].J Clin Invest,2008,118(4):1291-1300.
7. Tiewsoh K,Lodha R,Pandey RM,et al.Factors determining the outcome of children hospitalized with severe pneumonia[J].BMC Pediatr,2009,9:15.
8. Chisti MJ,Salam MA,Ashraf H,et al.Clinical risk factors of death from pneumonia in children with severe acute malnutrition in an urban critical care ward of Bangladesh[J].PLoS One,2013,8(9):e73728.
9. Okiro EA,Ngama M,Bett A,et al.Factors associated with increased risk of progression to respiratory syncytial virus-associated pneumonia in young Kenyan children[J].Trop Med Int Health,2008,13(7):914-926.
10. Lupisan SP,Ruutu P,Erma Abucejo-Ladesma P,et al.Predictors of death from severe pneumonia among children 2-59 months old hospitalized in Bohol,Philippines:implications for referral criteria at a first-level health facility[J].Trop Med Int Health,2007,12(8):962-971.
11. Rudan I,Tomaskovic L,Boschi-Pinto C,et al.Global estimate of the incidence of clinical pneumonia among children under five years of age[J].Bull World Health Organ,2004,82(12):895-903.
12. 徐苹,王强.血清降钙素原在婴幼儿重症肺炎早期诊断中的价值[J].现代实用医学,2010,22(10):1176-1177.
13. 董宗祈.呼吸系统的防御功能及其保护措施[J].实用儿科临床杂志,2004,19(2):158-160.
14. 范志忠,赵勇,吴永,等.164例婴幼儿重症肺炎高危因素分析[J].中华全科医学,2009,7(4):370-371.
15. 杨小青,黄英.儿童重症肺炎的高危因素认识及其对策[J].儿科药学杂志,2010,16(2):55-57.
16. 陈爱斌.婴幼儿重症肺炎死亡高危因素分析[J].实用全科医学,2005,3(5):437-438.
17. 丁小芳,张兵,钟礼立,等.儿童重症社区获得性肺炎病毒学检测和危险因素分析[J].中国当代儿科杂志,2012,14(6):449-453.
18. 刘钊锋.小儿难治性肺炎病因分析及治疗观察[J].临床医学,2012,32(3):95-96.
19. Wunderink RG,Mendelson MH,Somero MS,et al.Early microbiological response to linezolid vs vancomycin in ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus[J].Chest,2008,134(6):1200-1207.
20. 李玖军,刘春峰,袁壮,等.婴幼儿先天性心脏病合并重症肺炎的治疗[J].中国当代儿科杂志,2009,11(8):635-637.
21. 姜大朋.小儿围手术期低体温及防治[J].中国实用护理杂志,2005,21(14):62-63.

West China Medical Journal

Analysis of High-risk Factors for Death in Infants with Severe Pneumonia

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